David Versus Goliath: The Clinical Consequences of an Influenza A Viral Infection in an Unvaccinated Patient

Taylor S Harmon,Quan D Nguyen,Juan P Olano,Cihan Duran,Shaunak Patel

doi:10.7759/cureus.4788

Abstract

Acute influenza virus (AIV) infection can manifest as a severe life-threating illness in patients who are not vaccinated, and furthermore, have comorbidities that place them at risk for rapid respiratory decompensation. Each year influenza causes death in individuals with high risk for contracting this infection, although the illness is preventable by vaccination. Complications of AIV infection, such as bacterial pneumonia are treatable, but other severe complications such as acute respiratory distress syndrome (ARDS) leading to diffuse alveolar damage (DAD) are limited to supportive therapy and self-resolution. In most cases, ARDS leading to DAD is fatal, due to the insidious severity of symptoms which lead to rapid oxygen desaturation without correction, and despite supportive therapy. Regardless of a poor prognosis, the clinical signs and symptoms are congruent with imaging and attest to the importance of vaccination, which protect against high mortality rates.

Highlights

Every year, influenza is observed by surveillance entities that exist within the local, state, and national levels
acute respiratory distress syndrome (ARDS) leading to diffuse alveolar damage (DAD) is fatal, due to the insidious severity of symptoms which lead to rapid oxygen desaturation without correction, and despite supportive therapy
Regardless of a poor prognosis, the clinical signs and symptoms are congruent with imaging and attest to the importance of vaccination, which protect against high mortality rates

Summary

Introduction

Influenza is observed by surveillance entities that exist within the local, state, and national levels. In two of the cases (33%), diffuse alveolar damage (DAD) was identified in the setting of acute respiratory distress syndrome (ARDS). An initial chest radiograph of the patient demonstrates diffuse and bilateral pulmonary opacities (red arrows), significant for acute respiratory distress syndrome. At this time, the etiology for acute influenza A virus is unknown, but the nidus of disease is suspected to be an infection. There is worsening bilateral pulmonary opacities (red arrows) present as a result of acute respiratory distress syndrome. The autopsy results of the patient confirmed the presence of ARDS by demonstrating DAD without significant evidence for the superimposition of bacterial pneumonia (Figure 4).

Discussion

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Conclusions

Disclosures